Correction of lower eyelid retraction combined with entropion in thyroid eye disease patients of East Asian ancestry

2021 ◽  
pp. 112067212110356
Author(s):  
Yue Ma ◽  
Meiting Tang ◽  
Don O Kikkawa ◽  
Wei Lu
Keyword(s):  
East Asian ◽  
Lower Eyelid ◽  
Thyroid Eye Disease ◽  
Biomechanical Analysis ◽  
Eye Disease ◽  
Orbital Decompression ◽  
Eyelid Retraction ◽  
Asian Ancestry ◽  
The Difference ◽  
East Asian Ancestry

Purpose: This study evaluates causes and treatment of lower eyelid retraction with co-existing entropion in Thyroid Eye Disease (TED) patients of East Asian ancestry. Methods: The medical records for 25 eyelids from 15 TED patients with lower eyelid retraction and entropion who had undergone combined orbital decompression and lower eyelid retraction correction surgery at the Second Hospital of Dalian Medical University from January 2017 to December 2018 were prospectively reviewed. We build a numerical model of biomechanics to analyze von Mises stress and displacement at the lower eyelid. Results: The mean follow-up duration was 6 ± 2 months. The difference of mean exophthalmos was 5.16 ± 1.21 mm ( t = 21.26, p = 4.479E-17 < 0.05). The difference of mean MRD2 was 1.9 ± 0.14 mm ( t = 67.57, p = 6.751E-29 < 0.05). About 2 of 25 eyelids entropion recurred postoperatively; the overall success rate was 92%. The biomechanical analysis results reveal that the eyelid margin is given more stress and caused more displacement in East Asian ancestry under the same force of pressure. Conclusions: This study shows that the lower eyelid retraction with coexistent entropion is attributable to the unique anatomical features of patients of East Asians ancestry. We corrected the lower eyelid retraction and entropion during the orbital decompression operation. The results show that this method is safe and effective. It can simultaneously improve the symptoms of TED patients such as exophthalmos, lower eyelid retraction, and entropion, with minimal complications.

Treatment Options for Lower Eyelid Retraction in Thyroid Eye Disease

2021 ◽  
Vol 61 (2) ◽  
pp. 145-159
Author(s):  
Sanja G. Cypen ◽  
Jordan R. Conger ◽  
Lauren E. Chen ◽  
Jeremiah P. Tao
Keyword(s):  
Treatment Options ◽  
Lower Eyelid ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Eyelid Retraction

Analysis of Lid Contour in Thyroid Eye Disease With Upper and Lower Eyelid Retraction Using Multiple Radial Midpupil Lid Distances

2016 ◽  
Vol 27 (1) ◽  
pp. 134-136 ◽  
Author(s):  
Dongwan Kang ◽  
Joonsik Lee ◽  
Jinhwan Park ◽  
Hwa Lee ◽  
Minsoo Park ◽  
...  
Keyword(s):  
Lower Eyelid ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Eyelid Retraction

scholarly journals Correlation between uniocular deviation and duction changes following different decompression surgeries in thyroid eye disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jie Guo ◽  
Xiaofeng Li ◽  
Ruiqi Ma ◽  
Jiang Qian
Keyword(s):  
Computed Tomography ◽  
Lateral Wall ◽  
Contractile Force ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Decompression Surgery ◽  
Inferior Wall ◽  
Orbital Decompression ◽  
Significant Difference ◽  
Ocular Deviation

Abstract Background Postoperative ocular imbalance is an important problem for orbital decompression surgery in thyroid eye disease (TED). The aim of this study was to evaluate the changes in unilateral ocular deviation and duction following orbital decompression and discuss the biomechanics of ocular imbalance. Methods Fifty-four TED patients who underwent unilateral orbital decompression were included. Fifteen patients underwent 1-wall (deep lateral wall) decompression, 18 patients underwent 2-wall (deep lateral and medial wall) decompression and 21 patients underwent 3-wall (deep lateral, medial and inferior wall) decompression. Objective and subjective deviation of the operated eyes were evaluated using the prism test and synoptophore, respectively. Ocular ductions were measured using Hirschberg’s method. The diameters of the extraocular rectus were measured by computed tomography. Results Ocular deviation and duction showed no significant difference after 1-wall decompression (p = 0.25–0.89). Esotropia increased after 2-wall decompression (p = 0.001–0.02), and hypotropia increased after 3-wall decompression (p = 0.02). Adduction increased but abduction decreased following 2-wall and 3-wall decompression (p < 0.05). Infraduction increased following 3-wall decompression (p < 0.001). Additionally, the increase in esotropia was significantly correlated with the increase in adduction and with the decrease in abduction (r = 0.37–0.63, p < 0.05). There were significant correlations between the diameter of the medial rectus and the increase in esotropia, the increase in adduction and the decrease in abduction postoperatively (r = 0.35–0.48, p < 0.05). Conclusions The changes in ocular deviation and duction were different after 1-wall, 2-wall and 3-wall orbital decompression. The increased contractile force of the rectus may be an important reason for strabismus changes after orbital decompression surgery.

scholarly journals Patients’ expectations for the functional and psychosocial outcomes of orbital decompression surgery for thyroid eye disease: a qualitative study

2017 ◽  
Vol 23 (4) ◽  
pp. 475-484
Author(s):  
Sadie Wickwar ◽  
Hayley McBain ◽  
Matthew R. Edmunds ◽  
Daniel G. Ezra ◽  
Geoffrey E. Rose ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Psychosocial Outcomes ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Decompression Surgery ◽  
Orbital Decompression

scholarly journals Correlation Between Uniocular Deviation and Duction Changes Following Different Decompression Surgeries in Thyroid Eye Disease

2020 ◽  
Author(s):  
Jie Guo ◽  
Xiaofeng Li ◽  
Ruiqi Ma ◽  
Jiang Qian
Keyword(s):  
Lateral Wall ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Decompression Surgery ◽  
Inferior Wall ◽  
Orbital Decompression ◽  
Orbital Cavity ◽  
Significant Difference ◽  
Ocular Deviation ◽  
Fellow Eyes

Abstract Background: Postoperative ocular imbalance is an important problem for orbital decompression surgery in thyroid eye disease (TED). To evaluate the changes of unilateral ocular deviation and duction following orbital decompression and discuss the possible biomechanics of ocular imbalance.Methods: Fifty-four TED patients who underwent unilateral orbital decompression were included. 15 patients underwent 1-wall (deep lateral wall) decompression, 18 patients underwent 2-wall (deep lateral and medial wall) decompression and 21 patients underwent 3-wall (deep lateral, medial and inferior wall) decompression. Objective and subjective deviation of the operated eyes compared with the fellow eyes were evaluated using prism test and synoptophore, respectively. Ocular ductions were measured using Hirschberg’s method. The diameters of extraocular rectus were measured by computed tomography.Results: Ocular deviation and duction showed no significant difference after 1-wall decompression (p=0.25~0.89). Esotropia increased after 2-wall decompression (p=0.001~0.02). Hypotropia increased after 3-wall decompression (p=0.02). Adduction increased but abduction decreased following 2-wall and 3-wall decompression (p<0.05). Infraduction increased following 3-wall decompression (p<0.001). Additionally, the increase of esotropia had significant correlations with the increase of adduction and with the decrease of abduction (r=0.37~0.63, p<0.05). There were significant correlations between the diameter of medial rectus and the increase of esotropia, the increase of adduction and the decrease of abduction postoperatively (r=0.35~0.48, p<0.05).Conclusions: The changes in ocular deviation and duction were different after 1-wall, 2-wall and 3-wall orbital decompression. The expansion of orbital cavity and the increased contractile force of rectus might be important reasons for strabismus changes following decompression surgery.

Sign in / Sign up

Export Citation Format

Share Document